Juicebox Podcast: Type 1 Diabetes

Episode #1824: "Insurance Let Me Down – Part 1"

Host: Scott Benner
Guest: Laura Keller
Date: April 14, 2026

Episode Overview

In this episode, Scott Benner invites Laura Keller, a seasoned diabetes advocate and person with type 1 diabetes, to share her decades-long professional and personal experience. The main focus is Laura’s recent, deeply frustrating ordeal with insurance coverage for diabetes technology, despite being highly knowledgeable and proactive. Their honest, wide-ranging discussion offers valuable strategies, validation, and solidarity to people navigating the healthcare system with a chronic illness, especially diabetes.

Key Discussion Points and Insights

1. Laura Keller's Background and Perspective

Laura is 52, identifies as Gen X, and has lived with type 1 diabetes for 27 years.
She spent 25 years at the American Diabetes Association (ADA), mostly in advocacy, rising to VP of grassroots advocacy.
Laura is passionate about nonprofit work and continues consulting and volunteering post-retirement.
Early career included working with diabetic camps, family retreats, fundraising events, and later, significant advocacy for people with diabetes (02:42–04:26).

Notable Quote:
"I got really into advocacy, not because I thought that was going to be a career, but... I retired from the ADA about three years ago now as the vice president of grassroots advocacy."
— Laura (03:35)

2. Gen X Mentality, Direct Communication, and Self-Advocacy

Scott and Laura reflect on their Gen X upbringing and its impact on confidence and self-advocacy.
Discuss gender differences in advocacy, especially in healthcare and educational settings.
Women often dismissed as “emotional” when advocating for children with T1D, making male ally presence and even sending communications from a husband’s email more effective (11:12–13:04).

Notable Quote:
"If you have to, just bring a man, even if the man is your bartender, your dad, your hairdresser, it doesn't matter. You put a man in that room... they'll take you more seriously. I also used to tell moms... send the email... from your husband's email address... Every single time... they would get a better response."
— Laura (11:45–13:04)

Notable Quote:
"People have baked in preconceptions. I don't think they're conscious even."
— Scott (16:32)

3. Family Diabetes History and Shifting Standards of Care

Laura’s father and his half-brother were diagnosed with T1D at similar ages. Her mother, a nurse, was advised not to have children due to risk, but ignored the advice.
Major differences in diabetes management over a generation: her father used outdated insulin regimens until Laura’s diagnosis prompted advocacy and modern care implementation.
Family humor and resilience helped normalize living with diabetes (17:53–24:30).

Notable Quote:
"Once I got diagnosed and I realized how different his diabetes management was compared to what mine was... that was just shocking to realize that he was working on old data."
— Laura (19:42)

After connecting her father with modern resources and endocrinologists, his diabetes care improved dramatically.
Family background is Swedish/Nordic, which both Scott and Laura note appears correlated with higher T1D prevalence (26:28–27:28).

4. Laura’s Career at the ADA and Shifts in Diabetes Advocacy

Laura shares pride in legislative successes in protecting children with diabetes in schools—but notes setbacks and rollbacks in protections, costs, and access to care in recent years (27:39–28:49).
Specific concern: the Department of Education revoking disabilities protections, school systems questioning children's need for 504 plans and their right to accommodations (28:54–30:08).
The conversation pivots to the central theme: insurance barriers and Laura's recent personal experience.

5. Laura’s Insurance Ordeal—A Case Study in Barriers to Diabetes Tech

Researching and Selecting a Plan (32:24–34:02)

Laura, an expert on advocacy and insurance, thoroughly researched all options for coverage when her previous insurance plan left Arizona.
She double-checked provider directories, formularies (PDLs), and even used AI for further confirmation; everything indicated proper coverage.

Notable Moment:
"I looked at the other plans. I looked at who covers my endocrinologist, all of the things... I searched for insulin, I searched for insulin pumps, I search for CGMs... Nothing came up... that must mean they cover those things, right?"
— Laura (32:20–33:18)

Denials and Brick Walls (34:02–39:02)

Upon trying to refill necessary supplies, both her CGM and Pods were denied for “not medically necessary.”
Repeated phone calls, appeals, continual requirements for more paperwork, claim denials with no notification, and lack of information transparency.
Emotional and logistical burnout—frustration leading Laura, seasoned and tough, to tears.

Quotes:
"I started crying. I started crying because I was so mad at myself... and they so didn't understand what type 1 diabetes was."
— Laura (37:31–37:54)

Playing the ‘Paperwork Game’ and Systemic Sabotage (39:06–41:06)

Endless cycle of resubmitting paperwork, miscommunication between insurer and endo’s office, and lack of clarity frustrate the process for weeks.
Only persistent, near-daily follow-up barely keeps the process moving.
Support from Omnipod (“best customer service in the world”) and local pharmacists is crucial, but ultimately, the insurance makes it almost impossible to get coverage.

Notable Moment:
"If you don't like people with type 1 diabetes, just put it on your damn website. Just be honest."
— Laura (40:49–41:06)

Scott’s Observation:
"The rigmarole is set up to try to get you to give up."
(41:06–41:11)

Financial Realities and Coverage Gaps (41:11–43:25)

Laura’s initial plan required a $5,000 deductible plus 40% coinsurance for Pods and CGMs. Even with a revised plan (after income change), she still faces steep co-pays until the out-of-pocket max is reached.
Insurer forces her to switch CGM brand (Libre instead of Dexcom), affecting the feature set she relies on for daily management.
Laura stresses that these are not just policy issues—they have direct, daily, negative impacts on health and quality of life.

Notable Quotes & Memorable Moments

Gen X resilience:
"That means to me, you don't piss me off. If you push me too far, I will find a way to come back and kick your ass. Ethically, of course." — Laura (04:33)
On external validation:
"It would bother me if everyone liked me. What would I be then, like, just this kind of milquetoast thing that is okay for everybody?" — Scott (07:41)
Insurance denial as the ultimate frustration:
"I was told by Ambetter that an insulin pump was not medically necessary..." — Laura (34:02)
Toxic paperwork:
"Even though I'm a trained professional... it's a lot. And I started crying. I started crying because I was so mad at myself, right?" — Laura (37:31)
Systemic barriers:
"The rigmarole is set up to try to get you to give up." — Scott (41:06)
Advocacy reality check:
"If you don't dog them and call them and call them, that's how people give up. That's how people spend all this money out of pocket." — Laura (41:11)
On insurer’s lack of transparency:
"You also could put a statement on your plan about how you cover type 1 diabetes ... just be honest." — Laura (40:49)

Important Segment Timestamps

Laura introduces herself (background in diabetes): 02:24–04:26
Gen X, communication, and advocacy style: 04:26–11:12
Educational/advocacy strategies for women: 11:12–13:04
Family diabetes history and generational change: 17:53–27:00
Challenges in insurance/ADA career perspective: 27:39–30:08
Super-detailed insurance story begins: 32:24
First coverage denials and emotional response: 34:02–39:02
Systemic insurance barriers and the role of persistence: 41:02–43:25

Tone and Takeaways

The tone is candid, relatable, and sometimes intentionally humorous—a safe space to acknowledge and vent about the true emotional and pragmatic toll of chronic illness administration.
The discussion is empowering; despite setbacks, Laura and Scott stress persistence, community, and self-advocacy.
Practical advice is woven throughout: don’t trust “comparable plans” at face value, overcommunicate, and tap into patient-as-consumer strategies.
The episode ends with Laura caught in the insurance labyrinth but determined to keep fighting—inspiring listeners not to give up and to seek community and resources.

Note: This is Part 1 of a two-part series; Part 2 continues Laura’s story with additional detail and strategies.

Juicebox Podcast: Type 1 Diabetes

Episode #1824: "Insurance Let Me Down – Part 1"

Host: Scott Benner
Guest: Laura Keller
Date: April 14, 2026

Episode Overview

Key Discussion Points and Insights

1. Laura Keller's Background and Perspective

Laura is 52, identifies as Gen X, and has lived with type 1 diabetes for 27 years.
She spent 25 years at the American Diabetes Association (ADA), mostly in advocacy, rising to VP of grassroots advocacy.
Laura is passionate about nonprofit work and continues consulting and volunteering post-retirement.
Early career included working with diabetic camps, family retreats, fundraising events, and later, significant advocacy for people with diabetes (02:42–04:26).

2. Gen X Mentality, Direct Communication, and Self-Advocacy

Scott and Laura reflect on their Gen X upbringing and its impact on confidence and self-advocacy.
Discuss gender differences in advocacy, especially in healthcare and educational settings.
Women often dismissed as “emotional” when advocating for children with T1D, making male ally presence and even sending communications from a husband’s email more effective (11:12–13:04).

Notable Quote:
"People have baked in preconceptions. I don't think they're conscious even."
— Scott (16:32)

3. Family Diabetes History and Shifting Standards of Care

Laura’s father and his half-brother were diagnosed with T1D at similar ages. Her mother, a nurse, was advised not to have children due to risk, but ignored the advice.
Major differences in diabetes management over a generation: her father used outdated insulin regimens until Laura’s diagnosis prompted advocacy and modern care implementation.
Family humor and resilience helped normalize living with diabetes (17:53–24:30).

After connecting her father with modern resources and endocrinologists, his diabetes care improved dramatically.
Family background is Swedish/Nordic, which both Scott and Laura note appears correlated with higher T1D prevalence (26:28–27:28).

4. Laura’s Career at the ADA and Shifts in Diabetes Advocacy

Laura shares pride in legislative successes in protecting children with diabetes in schools—but notes setbacks and rollbacks in protections, costs, and access to care in recent years (27:39–28:49).
Specific concern: the Department of Education revoking disabilities protections, school systems questioning children's need for 504 plans and their right to accommodations (28:54–30:08).
The conversation pivots to the central theme: insurance barriers and Laura's recent personal experience.

5. Laura’s Insurance Ordeal—A Case Study in Barriers to Diabetes Tech

Researching and Selecting a Plan (32:24–34:02)

Laura, an expert on advocacy and insurance, thoroughly researched all options for coverage when her previous insurance plan left Arizona.
She double-checked provider directories, formularies (PDLs), and even used AI for further confirmation; everything indicated proper coverage.

Denials and Brick Walls (34:02–39:02)

Upon trying to refill necessary supplies, both her CGM and Pods were denied for “not medically necessary.”
Repeated phone calls, appeals, continual requirements for more paperwork, claim denials with no notification, and lack of information transparency.
Emotional and logistical burnout—frustration leading Laura, seasoned and tough, to tears.

Quotes:
"I started crying. I started crying because I was so mad at myself... and they so didn't understand what type 1 diabetes was."
— Laura (37:31–37:54)

Playing the ‘Paperwork Game’ and Systemic Sabotage (39:06–41:06)

Endless cycle of resubmitting paperwork, miscommunication between insurer and endo’s office, and lack of clarity frustrate the process for weeks.
Only persistent, near-daily follow-up barely keeps the process moving.
Support from Omnipod (“best customer service in the world”) and local pharmacists is crucial, but ultimately, the insurance makes it almost impossible to get coverage.

Notable Moment:
"If you don't like people with type 1 diabetes, just put it on your damn website. Just be honest."
— Laura (40:49–41:06)

Scott’s Observation:
"The rigmarole is set up to try to get you to give up."
(41:06–41:11)

Financial Realities and Coverage Gaps (41:11–43:25)

Laura’s initial plan required a $5,000 deductible plus 40% coinsurance for Pods and CGMs. Even with a revised plan (after income change), she still faces steep co-pays until the out-of-pocket max is reached.
Insurer forces her to switch CGM brand (Libre instead of Dexcom), affecting the feature set she relies on for daily management.
Laura stresses that these are not just policy issues—they have direct, daily, negative impacts on health and quality of life.

Notable Quotes & Memorable Moments

Gen X resilience:
"That means to me, you don't piss me off. If you push me too far, I will find a way to come back and kick your ass. Ethically, of course." — Laura (04:33)
On external validation:
"It would bother me if everyone liked me. What would I be then, like, just this kind of milquetoast thing that is okay for everybody?" — Scott (07:41)
Insurance denial as the ultimate frustration:
"I was told by Ambetter that an insulin pump was not medically necessary..." — Laura (34:02)
Toxic paperwork:
"Even though I'm a trained professional... it's a lot. And I started crying. I started crying because I was so mad at myself, right?" — Laura (37:31)
Systemic barriers:
"The rigmarole is set up to try to get you to give up." — Scott (41:06)
Advocacy reality check:
"If you don't dog them and call them and call them, that's how people give up. That's how people spend all this money out of pocket." — Laura (41:11)
On insurer’s lack of transparency:
"You also could put a statement on your plan about how you cover type 1 diabetes ... just be honest." — Laura (40:49)

Important Segment Timestamps

Laura introduces herself (background in diabetes): 02:24–04:26
Gen X, communication, and advocacy style: 04:26–11:12
Educational/advocacy strategies for women: 11:12–13:04
Family diabetes history and generational change: 17:53–27:00
Challenges in insurance/ADA career perspective: 27:39–30:08
Super-detailed insurance story begins: 32:24
First coverage denials and emotional response: 34:02–39:02
Systemic insurance barriers and the role of persistence: 41:02–43:25

Tone and Takeaways

The tone is candid, relatable, and sometimes intentionally humorous—a safe space to acknowledge and vent about the true emotional and pragmatic toll of chronic illness administration.
The discussion is empowering; despite setbacks, Laura and Scott stress persistence, community, and self-advocacy.
Practical advice is woven throughout: don’t trust “comparable plans” at face value, overcommunicate, and tap into patient-as-consumer strategies.
The episode ends with Laura caught in the insurance labyrinth but determined to keep fighting—inspiring listeners not to give up and to seek community and resources.

Note: This is Part 1 of a two-part series; Part 2 continues Laura’s story with additional detail and strategies.

wavePod

#1824 Insurance Let Me Down - Part 1

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1824: "Insurance Let Me Down – Part 1"

Episode Overview

Key Discussion Points and Insights

1. Laura Keller's Background and Perspective

2. Gen X Mentality, Direct Communication, and Self-Advocacy

3. Family Diabetes History and Shifting Standards of Care

4. Laura’s Career at the ADA and Shifts in Diabetes Advocacy

5. Laura’s Insurance Ordeal—A Case Study in Barriers to Diabetes Tech

Researching and Selecting a Plan (32:24–34:02)

Denials and Brick Walls (34:02–39:02)

Playing the ‘Paperwork Game’ and Systemic Sabotage (39:06–41:06)

Financial Realities and Coverage Gaps (41:11–43:25)

Notable Quotes & Memorable Moments

Important Segment Timestamps

Tone and Takeaways

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1824: "Insurance Let Me Down – Part 1"

Episode Overview

Key Discussion Points and Insights

1. Laura Keller's Background and Perspective

2. Gen X Mentality, Direct Communication, and Self-Advocacy

3. Family Diabetes History and Shifting Standards of Care

4. Laura’s Career at the ADA and Shifts in Diabetes Advocacy

5. Laura’s Insurance Ordeal—A Case Study in Barriers to Diabetes Tech

Researching and Selecting a Plan (32:24–34:02)

Denials and Brick Walls (34:02–39:02)

Playing the ‘Paperwork Game’ and Systemic Sabotage (39:06–41:06)

Financial Realities and Coverage Gaps (41:11–43:25)

Notable Quotes & Memorable Moments

Important Segment Timestamps

Tone and Takeaways